The fact that Omicron was detected in an individual who had arrived in Nepal five days before the new variant was first identified in Botswana is proof it was already circulating and travel bans do not work.
The new strain has been detected in over 40 countries mere two weeks after it was first detected. What is known so far of Omicron is that it is highly transmissible but likely not very severe as there has been no significant increase in hospitalisations among infected individuals in places with outbreaks.
“Looking at preliminary findings I don’t think it will lead to another major surge or lockdowns like Delta, but having said that we must be prepared and contain it to prevent further mutation and more virulent strains,” says epidemiologist Lhamo Yangchen Sherpa of IPAS Nepal.
She adds: “We do that by vaccinating as many people as possible including boosters if they are nearing expiry date as we know them to be, following safety measures especially indoors and by better communicating government policies to control the spread of new strains.”
One of the main concerns with Omicron is mutations in the spike protein that binds it to the receptor. Most vaccines including Pfizer, Moderna, AstraZeneca and J&J primarily target this spike protein, so there are worries that the new variant will escape immunity afforded by jabs.
Mutations are natural, but coronaviruses make fewer of them than other viruses because of their much stronger proofreading system to survive.
Speaking with India Spend, Polly Roy, professor of virology at the London School of Hygiene & Tropical Medicine said: ‘Even though we have a mutation, it’s not in the receptor-binding site area so much. Thus, if they change too much, the virus will not bind to host cells and will not survive. And the vaccines target that area, so the vaccines will still work against Omicron infection.’
Says infectious disease specialist at HAMS Hospital Anup Subedee: “Even if the vaccines are less effective against this variant, it will still provide significant immunity to fight off new infections. And given that antibodies wane over time, Nepal’s frontline workers and the elderly should be prioritised for boosters, if possible with vaccines known to have higher efficacy.”
There are also concerns that despite registering only mild symptoms Omicron could affect vulnerable populations much later as it is the younger mobile population who are usually infected first without much impact on their health.
Most of the initial Omicron infections are said to be mild and among young and vaccinated people, which means Nepal could be ripe for another surge.
“Don’t be surprised if we do,” says Sushil Koirala, a Nepali public health expert based in Bangkok. “We have all the necessary fuel to start the wildfire: low vaccination coverage, poor adherence to public health measures, lackluster preparedness, and questionable surveillance,” Koirala warns.
But the moral dilemma over booster remains when over 60% of Nepal’s targeted population is yet to even receive the first dose.
“In an ideal world, universal coverage is the way to go but the government hasn’t been able to vaccinate the majority of Nepalis, so we cannot wait forever for boosters either,” adds Subedee.